Patients’ Families, Physicians, and Nurses: Trying to See Eye-to-Eye Regarding Prognosis in Neurocritical Care

Excerpt

Early impressions of prognosis among surrogate decision makers, physicians, and nurses for patients with severe acute brain injury (SABI) are clearly critical to making shared decisions regarding aggressiveness of care. These decisions are much tougher when clinical teams and families are not on the same page. In a recent article, Kiker et al. [1] reported that, among 61% of 193 patients with SABI hospitalized in a single center in Seattle, a physician on the treatment team and a key member of the patient’s family had early impressions of how likely the patient was to recover to functional independence that differed by more than 20 points when assessed on a 100-point scale. In this issue of Neurocritical Care, the authors continue their analysis and examine degrees of agreement regarding early impressions of prognosis, not just between family members and physicians, but for both groups compared with bedside nurses’ impressions, as well [2]. They also report the accuracy of these impressions across all three groups. …